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Therapeutic Video Games Exist, and You Are Already Playing Some

In a previous blog post, I wrote that research has shown that video games may be linked to mental illness. It turns out that this was only part of the story. Therapeutic video games exist, and you are already playing some of them. A large body of research is identifying therapeutic video games and demonstrating ways in which they can help treat ailments such as anxiety, PTSD, depression, cerebral palsy, and other emotional and physical illnesses. And this research is not confined to games created in a university laboratory; it includes many popular off-the-shelf video games that were produced primarily for entertainment value.

A competing body of research exists, however–also recognized by the APA–regarding therapeutic video games. The APA issued the following statement in 2014:

“Playing video games, including violent shooter games, may boost children’s learning, health and social skills, according to a review of research on the positive effects of video game play to be published by the American Psychological Association.”

“The vast majority of research by psychologists on the effects of “gaming” has been on its negative impact: the potential harm related to violence, addiction, and depression. We recognize the value of that research; however, we argue that a more balanced perspective is needed, one that considers not only the possible negative effects but also the benefits of playing these games.”

The researchers identified two categories of video games: sedentary games and “exergames”. Researchers identified some “exergames” with which you are probably already familiar: Wii Virtual Reality games, Wii Fit, Wii Sports (in particular boxing and bowling) and Dance Dance Revolution. Regarding Dance Dance Revolution, the researchers had the following to say:

“[A]lthough the video game Dance Dance Revolution was not designed specifically to treat childhood obesity, it has been shown to be an effective aerobic workout that promotes weight loss in childhood obesity.”

The researchers also noted that “Wii Boxing and Bowling games have been effective in neurorehabilitation of adults with Parkinson’s disease and stroke.”

“Video games certainly employ mechanisms to increase motivation and reward (e.g., through plotlines, point systems and unlocking new games or levels), and enjoyment of movement-based video games and [virtual reality technologies] is reportedly high in children with [cerebral palsy].”

“EGE has been investigated as an adjunct to individual and group psychotherapy, primarily in behavioral or talk therapy with children or adults with developmental delays. A variety of commercially produced games are appropriate to use . . .”

The authors identified several examples of such games targeting different therapeutic outcomes, listed in this table:

Therapeutic video games include off-the-shelf games designed primarily for entertainment.

The authors also acknowledged research that:

“describe[s] the use of imagery in a first-person shooter game to allow patients with brain tumors to experience an imagined immune response to the tumors. In a randomized clinical trial (RCT), significant reductions were noted by the authors in depression, anxiety, anger, and disruptive behavior and increases in self-concept, with significant advantages of the intervention over the control in all areas.”

“[i]n a systematic review of ten experimental studies using VRET [virtual reality entertainment technology] in combination with [cognitive-behavioral therapy] in the treatment of PTSD, VRET was found to be at least as useful as traditional exposure therapy.”

The authors concluded that “EGE, using off-the-shelf games, are easier and less expensive to acquire and update, provide a much larger set of options, and are generally more preferred by children and adolescents.” They also provided clinical recommendations and described their own clinic:

“The authors have a variety of computer-based and console-based games . . . In using EGE for groups, we use games that allow as many clients to participate as possible; for a single console, the best option at this time is the Wii U with up to five players at a time; for multiple consoles, three Xbox 360 consoles can accommodate up to 12 players at a time.”

(Remember, the authors published this review in 2014, prior to wide adoption of current generation gaming consoles).

You have heard of the popular brain-training gaming suite Luminosity. Luminosity (the company) claims that it partners with the scientific community to provide a suite of games that improve cognitive performance. According to Brenda Goodman, MA of WebMD, in a 2014 piece entitled The Promise and Perils of Brain Training, consumers are spending $1.3 billion on gaming products such as Luminosity, a number that increases each year.

The Stanford Statement and ensuing debate.

“We object to the claim that brain games offer consumers a scientifically grounded avenue to reduce or reverse cognitive decline when there is no compelling scientific evidence to date that they do. The promise of a magic bullet detracts from the best evidence to date, which is that cognitive health in old age reflects the long-term effects of healthy, engaged lifestyles. In the judgment of the signatories, exaggerated and misleading claims exploit the anxiety of older adults about impending cognitive decline. We encourage continued careful research and validation in this field.”

“There is, in fact, a large and growing body of such evidence [regarding brain games]. That evidence now includes dozens of randomized, controlled trials published in peer-reviewed journals that document specific benefits of defined types of cognitive training. Many of these studies show improvements that encompass a broad array of cognitive and everyday activities, show gains that persist for a reasonable amount of time, document positive changes in real-life indices of cognitive health, and employ control strategies designed to account for “placebo” effects.”

Concluding Thoughts: Many therapeutic video games exist, most of which are off-the-shelf games that gamers already play.

While controversy remains regarding the relative value of therapeutic video games, a wide body of research exists that identifies their value, going so far as to even identify specific mass-market video games. Some bad actors, such as Luminosity, have stretched this research into unsupportable marketing claims, but the research exists and is real. Therapeutic video games do exist, and you either have played or are already playing them.

Additional reading regarding research into therapeutic video games.

This post already runs long, so for the sake of (relative) brevity, I am listing some links to further reading without providing any commentary.